TIFFANY L MEINERT Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****95

License Status

NOT RENEWED

Business

First Name

TIFFANY

Middle

Last Name

MEINERT

Business Name

TIFFANY L MEINERT

Original Issue Date

09/03/2008

Effective Date

01/25/2012

Expiration Date

03/01/2014

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

12/15/2015